This case report describes an iatrogenic right coronary artery-to-right ventricle fistula resulting from percutaneous transluminal coronary angioplasty. In this patient transthoracic echocardiography with Doppler color flow mapping allowed direct visualization of the right coronary artery aneurysm and the coronary fistula, enabling us to identify the cardiac chamber into which the ...

Thrombosis is an obligatory consequence of all percutaneous vascular interventions. Balloon angioplasty, intravascular stents and other devices routinely used to facilitate dilatation of critical vascular stenoses result in fracture of the intima and exposure of the thrombogenic subendothelium with initiation and perpetuation of platelet activation and aggregation. This not uncommonly ...

Implementing the evidence base for the management of chronic disease is as challenging as discovering which interventions are effective. The HEARTS collaboration (Heart disease Evidence-based Audit and Research in Tayside Scotland) is achieving that goal for the secondary prevention of coronary heart disease (CHD by linking national databases to manually ...

The elderly, women, and minorities are all less likely to be enrolled in randomized clinical trials (RCTs). Whether differential patient interest in RCTs contributes to these disparities is unclear. The authors surveyed 660 patients willingness to consider two potential cardiac RCTs of medical therapy vs. percutaneous coronary angioplasty or coronary ...

This article compares African American patients who entered the hospital with the same medical condition-acute myocardial infarction-to similar white patients to assess the relative contributions of insurance type and managed care to the race gap in access to three expensive invasive procedures for treating heart disease: cardiac catheterization, percutaneous transluminal ...

Spontaneous coronary artery dissection is an unusual cause of acute coronary syndrome. We describe a series of cases that with an early diagnosis and aggressive treatment, which includes percutaneous angioplasty with stent implantation and cardiac surgery, had a good outcome. The objective was to study the demographic characteristics, clinical settings, ...

From the available data, one cannot conclude whether thrombolytic therapy is beneficial or detrimental in patients older than age 75 years with acute myocardial infarction. Data favor the use of primary percutaneous transluminal coronary angioplasty rather than thrombolysis in eligible patients older than age 75 years with acute myocardial infarction ...

BACKGROUND: Angioplasty of an infarct related artery (IRA) performed several weeks or months after myocardial infarction (MI) may improve myocardial function. HYPOTHESIS: We hypothesized that, as Doppler myocardial imaging (DMI) allows for the quantitative assessment of the systolic movement of myocardial segments, it may be a sensitive method for assessing ...

The purpose of this study was to collect information on the practice and patient doses in a major Greek cardiac centre, investigate differences between senior cardiologists of various levels of experience and compare results with the literature, in order to optimize angiographic and interventional cardiology procedures. Radiation doses from 292 ...

Distal embolization of plaque or thrombotic debris is one of the mechanisms involved in the ischemia/reperfusion injury during primary percutaneous intervention for acute occlusion of a native coronary artery. We tested the clinical application of maximal antiplatelet therapy with abciximab combined with one of two different systems of mechanical distal ...

OBJECTIVES: The aim of the study was to evaluate the relationship between symptom-onset-to-balloon time and one-year mortality in patients with ST-segment elevation myocardial infarction (STEMI) treated by primary angioplasty. BACKGROUND: Despite the prognostic implications demonstrated in patients with STEMI treated with thrombolysis, the impact of time-delay on prognosis in patients ...

OBJECTIVE: Comparison of the long-term outcomes of three reperfusion strategies in patients with acute ST elevation myocardial infarction presenting to community hospitals. METHODS: One-year clinical outcomes were compared for 300 patients randomized in the PRimary Angioplasty in patients transferred from General community hospitals to specialized percutaneous coronary intervention Units with ...

BACKGROUND: Percutaneous transluminal coronary angioplasty of the infarct-related artery in stable survivors of acute myocardial infarction is often performed, even in patients without any symptoms or residual ischemia. Despite the lack of randomized studies, it is widely believed that this intervention will improve the clinical outcome of these patients. METHODS ...

BACKGROUND: Randomized trials have indicated that primary coronary angioplasty performed in patients admitted directly to highly-experienced angioplasty centers offers certain advantages over intravenous fibrinolytic therapy. However, the large majority of patients with acute myocardial infarction are submitted to hospitals without a catheterization laboratory. This means that additional transportation will be ...

We describe a case of rotational atherectomy (RA) used in the setting of extensive coronary dissection. Unsuccessful predilitation of a heavily calcified proximal LAD stenosis resulted in balloon rupture, which produced occlusive dissection extending into the mid LAD. Limited options for this patient required that we perform RA to permit ...

A 68-year-old man underwent percutaneous transluminal coronary angioplasty for unstable angina. During the balloon inflation, coronary artery dissection with total occlusion was noted and recanalized by coronary stenting. The serial electrocardiograms revealed ST segment and T wave changes without elevation of the cardiac isoenzyme, which is suggested to represent acute ...

OBJECTIVES: We sought to investigate the impact of circadian patterns in the onset of acute myocardial infarction (AMI) on the practice of primary angioplasty. BACKGROUND: A circadian variation in the time of onset of AMI with a peak in the morning hours has been described. METHODS: We studied 1,702 consecutive ...

BACKGROUND: Randomized trials comparing primary angioplasty and in-hospital fibrinolysis in acute myocardial infarction (AMI) have shown an advantage for primary angioplasty. The long-term follow-up of pre-hospital fibrinolysis followed by elective or rescue coronary angioplasty versus primary angioplasty is not well established after acute myocardial infarction. This study sought to assess ...

Effective risk stratification is essential in the management of patients with acute myocardial infarction. Available models have not yet been studied and validated in patients treated with primary angioplasty for acute myocardial infarction. The prognostic value of heart failure defined by Killip class and age upon admission and the impact ...

OBJECTIVE: The objective of this study is to assess the feasibility and safety of interhospital transfer (within up to 60 minutes) for primary/rescue coronary angioplasty of patients with myocardial infarction (AMI) complicated by an early onset of acute heart failure (AHF) admitted to a community hospital without PCI facilities. DESIGN ...

Angioplasty has long been used in the treatment of peripheral arterial occlusive disease with variable long-term results. In this case report, we present a patient with marfanoid features and acute ischemia of the lower extremity. Angioplasty provided us with the means of emergently relieving the acute symptoms. The patient was ...

BACKGROUND: Previous work has suggested that platelet glycoprotein IIb/IIIa receptor blockade may confer benefit in the treatment of acute myocardial infarction. The TIGER-PA pilot trial was a single-center randomized study to evaluate the safety, feasibility, and utility of early tirofiban administration before planned primary angioplasty in patients presenting with acute ...

The incidence of peripheral arteriosclerosis is on the increase in chronic hemodialysis patients. Recently, the intervention (IV) treatment is conducted to deal with this problem. IV was performed in 4 dialysis patients against the complication of arteriosclerosis obliterans (ASO) but the result was unsuccessful in 3 of them. These 3 ...

STUDY OBJECTIVE: To explore how the increased supply of coronary bypass operations and angioplasties from 1988 to 1996 influenced socioeconomic and gender equity in their use. DESIGN: Register based linkage study; information on coronary procedures from the Finnish Hospital Discharge Register in 1988 and 1996 was individually linked to national ...

Objectives. We sought to investigate the impact of circadian patterns in the onset of acute myocardial infarction on the practice of primary angioplasty. Background. A circadian variation in the time of onset of acute myocardial infarction with a peak in the morning hours has been described. Methods. We studied 1702 ...

To evaluate if QT dispersion (QTd) may be affected by the number of obstructed coronary arteries (CAs) in patients with acute myocardial infarction (MI) and undergoing angioplasty, and to evaluate if QTd may be affected by ejection function of the heart. The infarct related CA was identified by coronary angiography ...

Cutting balloon angioplasty can reduce the restenosis rate more than conventional balloon angioplasty, but is traditionally performed through a femoral artery. However, it is not clear how useful a transradial approach would be for cutting balloon angioplasty. This study was conducted to examine the safety, feasibility, and limitations of transradial ...

Discrete stenoses of the thoraco-abdominal aorta in non-specific aorto-arteritis are considered favorable lesions for balloon angioplasty characterized by good results without major complications. Herein, we describe one such case manifesting with severe hypertension, left ventricular dysfunction and congestive heart failure treated by angioplasty. Balloon dilatation, however, resulted in extensive dissection ...

We describe two patients in whom right coronary artery dissection and retrograde dissection of the sinus of Valsalva occurred during guidewire advancement for percutaneous coronary angioplasty Both patients were treated successfully by coronary stenting. These cases illustrate that contrast medium injection can detect early complications during guidewire advancement for coronary ...

Utilization of percutaneous interventions for arterial and venous occlusive lesions continue to increase. With the progression of the technology supporting these therapeutic measures, the results of these interventions may be expected to improve. In general, a comparison of techniques for revascularization demonstrates similar initial technical success rates for surgery and ...

OBJECTIVE: The purpose of this study was to determine whether Hu23F2G (LeukoArrest), an antibody to the CD11/CD18 integrin receptors, would reduce infarct size in patients undergoing primary angioplasty for an acute myocardial infarction. BACKGROUND: Reperfusion injury in acute myocardial infarction has been shown experimentally to be related to neutrophil accumulation. ...

OBJECTIVE: To determine the short term results and safety of angioplasty in chronic coronary occlusions. METHODS: Eighty consecutive patients undergoing percutaneous transluminal coronary angioplasty (PTCA) for chronic coronary occlusions were prospectively analyzed for acute success rate and safety of the procedure. RESULTS: The mean age was 46.7 years (range 30-78 ...

Primary angioplasty is superior to thrombolysis in acute myocardial infarction when performed in a timely manner but the benefits are unknown when inter-hospital transfer is required for angioplasty. On the 20th March 2002 at the American College of Cardiology 51st Annual Scientific Session, the results of the Danish Multicentre Randomized ...

BACKGROUND: Although both prehospital fibrinolysis and primary angioplasty provide a clinical benefit over in-hospital fibrinolysis in acute myocardial infarction, they have not been directly compared. Our aim was to find out whether primary angioplasty was better than prehospital fibrinolysis. METHODS: We did a randomised multicentre trial of 840 patients (of ...

BACKGROUND: The study aimed to investigate patient and spouse perception of cognitive functioning 1 to 2 years after coronary artery bypass grafting. METHODS: Seventy-six married patients who had undergone coronary artery bypass grafting were selected and sex- and age-matched with 75 concurrent married patients who had undergone percutaneous transluminal coronary ...

We describe a case of acute myocardial infarction related to a cerebellar hemorrhage. The infarction occurred just before the neurosurgical operation of ventricular drainage and was successfully treated by primary coronary angioplasty, with the implantation of coated stents and low doses of glycoprotein (GP) IIb/IIIa inhibitors. The patient recovered well ...

OBJECTIVE: To report procedural results and mortality rates from the first 4 years after establishing primary angioplasty as the preferred treatment for acute myocardial infarction in a single Scandinavian centre. DESIGN AND RESULTS: From August 1995 to October 1999 all patients with the diagnosis of suspected acute myocardial infarction (n ...

There is evidence that several classes of drugs are beneficial for secondary prevention in patients with coronary artery disease. To compare the use of secondary preventive drugs in patients with acute coronary syndromes given conservative treatment or percutaneous coronary interventions. The PREVENIR survey was designed to assess the management of ...

OBJECTIVE AND IMPORTANCE: Surgical sacrifice of the straight sinus may be performed during intracranial tumor resection. Sacrifice of the straight sinus is associated with an unpredictable risk of venous infarction. We describe a patient with a falcine meningioma who underwent endovascular balloon test occlusion of the straight sinus before surgical ...

AIMS: Although recognized as an important feature of atherosclerotic coronary disease, little is known about the frequency and prognostic importance of distal embolization during primary angioplasty for acute myocardial infarction. METHODS AND RESULTS: As part of a randomized trial of thrombolysis vs primary angioplasty, 178 patients with acute myocardial infarction ...